Title

Insurance status is a potent predictor of outcomes in both blunt and penetrating trauma.

Document Type

Article

Publication Date

4-1-2010

Identifier

DOI: 10.1016/j.amjsurg.2009.11.005

Abstract

BACKGROUND: Patients with penetrating injuries are known to have worse outcomes than those with blunt trauma. We hypothesize that within each injury mechanism there should be no outcome difference between insured and uninsured patients.

METHODS: The National Trauma Data Bank version 7 was analyzed. Patients aged 65 years and older and burn patients were excluded. The insurance status was categorized as insured (private, government/military, or Medicaid) and uninsured. Multivariate analysis adjusted for insurance status, mechanism of injury, age, race, sex, injury severity score, shock, head injury, extremity injury, teaching hospital status, and year.

RESULTS: A total of 1,203,243 patients were analyzed, with a mortality rate of 3.7%. The death rate was significantly higher in penetrating trauma patients versus blunt trauma patients (7.9% vs 3.0%; P < .001), and higher in the uninsured (5.3% vs 3.2%; P < .001). On multivariate analysis, uninsured patients had an increased odds of death than insured patients, in both penetrating and blunt trauma patients. Penetrating trauma patients with insurance still had a greater risk of death than blunt trauma patients without insurance.

CONCLUSIONS: Insurance status is a potent predictor of outcome in both penetrating and blunt trauma.

Journal Title

American journal of surgery

Volume

199

Issue

4

First Page

554

Last Page

557

MeSH Keywords

Adolescent; Adult; Child; Child, Preschool; Craniocerebral Trauma; Databases, Factual; Female; Healthcare Disparities; Humans; Infant; Injury Severity Score; Insurance Coverage; Insurance, Health; Length of Stay; Male; Medically Uninsured; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Retrospective Studies; Treatment Outcome; United States; Wounds, Nonpenetrating; Wounds, Penetrating; Young Adult

Keywords

Health Insurance; Outcomes; Blunt Trauma; Penetrating Trauma

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